[Proximal temporo-sylvian anastomosis with an arterial cuff glued with fibrin. Technical, anatomical and arteriographic considerations].

The authors present a new method of temporo-sylvian anastomosis used 8 times since 1982. This anastomosis called proximal is done on the insular segment (M2) of the sylvian artery and gives better revascularizations than the classic method (M4 or distal). The arterial cuff and the fibrin glue simplify, accelerate and improve the usual microsuture. A good knowledge about the microsurgical anatomy of the middle cerebral artery and its variants is important. The proximal sylvian artery and its perforators (50% occlusion in our cases) may be explored by this approach.